Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1366315020 Deactivated / Inactive NPI

Kalissa Patrice Johnson

Behavior Technician • Stockbridge, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kalissa Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 27, 2025
NPI Deactivation Date July 09, 2026
Total Practice Duration ~1 Years of Practice (2025 – 2026)

Professional Overview & Biography Verified Profile Summary

Kalissa Johnson was a registered Behavior Technician practicing in Stockbridge, GA. Throughout an active medical career spanning 1 years, Kalissa Johnson provided care at the practice location at 245 COUNTRY CLUB DR STE 100DEF until profile deactivation on 2026-07-09.

Practice Location & Contact Primary Location

Practice Address

245 Country Club Dr Ste 100def

Stockbridge, GA 302819080

Telephone 8774182978
Fax 8665002186
Associated Practice Facility / Clinic
🏢 Butterfly Effects Facility NPI 1548907553

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Technician in Stockbridge, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
204 Specialists

Practicing in Stockbridge, GA (12251 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Behavior Technician Primary Specialty

NUCC Taxonomy Code: 106S00000X

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Shadeed Hasan

Behavior Analyst

NPI 1003130626
NPI 1003268590

Master of Science, Board Certified Behavior Analyst

NPI 1003328030

Master of Science

Briana Guzman

Behavior Technician

NPI 1003395773
Elise Escobar

Behavior Analyst

NPI 1003397225
Haley Lessig

Behavior Technician

NPI 1003404807

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 09, 2026

Record deactivated on July 09, 2026

NPI Profile Active September 27, 2025

NPI status registered as active in NPPES database

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Updated Practice Location September 27, 2025

Registered at 245 COUNTRY CLUB DR STE 100DEF, STOCKBRIDGE, GA 302819080 (Tel: 8774182978)

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Updated Business Mailing Address September 27, 2025

Registered at 350 FAIRWAY DR STE 101, DEERFIELD BEACH, FL 334411834 (Tel: 8774182978)

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Provider Name / Credentials Updated September 27, 2025

Recorded as KALISSA JOHNSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 27, 2025

Behavior Technician

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Initial NPI Registration & Enumeration September 27, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366315020
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 27, 2025
Last Update: September 27, 2025
Deactivation Date: July 09, 2026

Mailing Address

350 Fairway Dr Ste 101

Deerfield Beach, FL 334411834

Phone: 8774182978

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.